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NPI 1497986145

NPI 1497986145 : YONG JI ZHAO D.C : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1497986145
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    Entity Type          |    Individual 
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    Provider Name        |    YONG JI ZHAO D.C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/29/2009
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    Last Update Date     |    07/29/2009
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Provider Practice Location Address
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    Address Line         |    4911 MAPLEWOOD AVE 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90004-2507
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    Country              |    US
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    Telephone            |    323-467-0088
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    Fax                  |    323-467-0688
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Provider Business Mailing Address
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    Address Line         |    4911 MAPLEWOOD AVE 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90004-2507
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    Country              |    US
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    Telephone            |    323-467-0088
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    Fax                  |    323-467-0688
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    DC25832
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    License Number State |    CA
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